Compliance Data Research Articles

Urethral monopolar cauterization: alternative infravesical obstruction model in male rats.

SUMMARYOBJECTIVE:We aimed to determine which method gives the most consistent results between urethral monopolar cauterization and standard urethral partial ligation methods for the urethral obstruction model.METHODS:Thirty male rats were randomly divided into control, partial ligation, and monopolar cauterization groups. Six weeks after experimental procedures, the experimental groups were evaluated cystometrically, biochemically, and histologically.RESULTS:According to the cystometric results, bladder capacity, baseline bladder pressure, and compliance data of the monopolar cauterization group were higher than those of the partial ligation and monopolar cauterization groups (p<0.05 and p<0.01, respectively). As a biochemical evaluation, malondialdehyde levels in bladder tissues of group control were higher than partial ligation and monopolar cauterization groups (p<0.05 and p<0.01, respectively). The collagen type I level of the control group was higher than the partial ligation and monopolar cauterization groups (p<0.01 and p<0.05, respectively). Collagen type III levels of the monopolar cauterization group were higher than those of the control group (p<0.01), but the Collagen type I/Collagen type III and transforming growth factor-β levels of the monopolar cauterization group were significantly lower than those of the control group (p<0.001). As a histological evaluation (hematoxylin and eosin), fibrosis in the lamina propria was more prominent in the monopolar cauterization group than in the control group (p<0.05). In addition, the muscular thickness was higher in the monopolar cauterization group compared with control and partial ligation groups (p<0.001 and p<0.01, respectively).CONCLUSION:The needle-tipped monopolar cauterization of the posterior urethra may be the method of choice for creating a chronic infravesical obstruction model of infravesical obstruction in male rats.

HUBUNGAN KARAKTERISTIK PASIEN RAWAT JALAN TUBERKULOSIS PARU TERHADAP TINGKAT KEPATUHAN MINUM OBAT DI PUSKESMAS SAWIT SEBERANG

Pulmonary tuberculosis is an infectious disease, so non-adherence to treatment will result in treatment failure, risk of death, and cause more patients to become resistant. This study aims to determine the relationship between the characteristics of pulmonary tuberculosis outpatients on the level of medication adherence in Sawit Seberang Public Health Center. This research was conducted with a cross sectional survey research method. The instrument used in this study was a validated questionnaire containing 8 questions about patient compliance and pill count data by calculating the patient's remaining medication. A total of 45 patients were used as respondents who had pulmonary tuberculosis. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 18 program. The results showed that the level of compliance of pulmonary tuberculosis patients in Sawit Seberang Public Health Center based on the questionnaire was high, namely 62.2%, and the compliance level of pulmonary tuberculosis patients in Sawit Seberang Public Health Center based on the Pill Count was perfect, namely 93.3%. Patient characteristics (gender, age, education, and occupation) did not affect the level of compliance of patients taking pulmonary tuberculosis drugs with p values of 0.462, 0.527, 0.260, 0.482 respectively. This study proves that the level of compliance of pulmonary tuberculosis patients in Sawit Seberang Public Health Center based on the questionnaire is high and based on the Pill Count is perfect. Patient characteristics (gender, age, education, and occupation) did not affect the patient's level of compliance to taking pulmonary tuberculosis drugs.

Legal Compliance and Good Data Stewardship in Data Sharing Plans

The sharing of health-related data is governed by myriad federal and state (and sometimes international) requirements. Moreover, these health-related data sharing rules are evolving, which poses a substantial challenge to creating long-term data management and sharing plans for National Institutes of Health (NIH)-funded or conducted research. To comply with inconsistent and evolving legal standards, the author recommends use of HIPAA’s Expert Determination Method to de-identify data. In addition, in light of concerns about whether de-identification of data is sufficient protection of privacy, and in the absence of a federal law prohibiting the re-identification of individuals in de-identified data sets, the author recommends utilizing contractual controls on the use of de-identified data and restrictions on downstream disclosures of that data.

Advancing Nursing Science Through Site-Based Clinical Inquiry: Designing Problem Pyramids.

Advancing Nursing Science Through Site-Based Clinical Inquiry: Designing Problem Pyramids.

On the anisotropic indentation modulus and anisotropic creep behavior of [formula omitted]-Sn characterized by nanoindentation methods

The influence of the orientation on the indentation modulus, the hardness and the creep properties of high purity β-Sn (wt.%: 99.999) have been examined. Nanoindentation methods were used in order to evaluate their potential usage for analyzing small volumina commonly found at solder joints. Crystal orientations close to <100>, <110> and <001> were identified using electron backscatter diffraction (EBSD). To determine the indentation modulus and hardness, continuous stiffness measurements (CSM) were carried out with a maximum load of 1 mN. The indentation moduli correspond in basic sequence to Young’s moduli calculated using compliance data of single crystalline β-Sn. The creep properties were investigated using a constant load of 10 mN over a duration of 10 min. An orientation dependence in the obtained values for the indentation modulus, the hardness and the creep properties could be detected by methods of nanoindentation and is discussed in this study.

General Data Protection Regulation (GDPR) Toolkit for Digital Health.

The General Data Protection Regulation (GDPR) entered into force on May 25, 2018. Compliance with GDPR is especially relevant to the Digital Health (DH) domain, as it is common to process highly sensitive personal data regarding a person's health. However, GDPR compliance is a very challenging process since it requires implementing several technical and organizational measures to maintain compliance. With the aim to facilitate this process, we reviewed the published best practices in GDPR compliance. Then, we customized the findings to fit into the DH domain and created a toolkit for GDPR implementation and compliance. The Activity Planning Tool (APT) is provided as an example of how this toolkit could be utilized in new application development in mobile health in Austria. In the case of our APT, the toolkit was very helpful in integrating the GDPR technical requirements in addition to creating the corresponding compliance impact assessment, processing agreements, privacy policy, data flowcharts, and compliance checklists.

Using Machine Learning on Imbalanced Guideline Compliance Data to Optimize Multidisciplinary Tumour Board Decision Making for the Management of Breast Cancer Patients.

Complex breast cancer cases that need further multidisciplinary tumor board (MTB) discussions should have priority in the organization of MTBs. In order to optimize MTB workflow, we attempted to predict complex cases defined as non-compliant cases despite the use of the decision support system OncoDoc, through the implementation of machine learning procedures and algorithms (Decision Trees, Random Forests, and XGBoost). F1-score after cross-validation, sampling implementation, with or without feature selection, did not exceed 40%.

Risk compliance and master data management in banking – A novel BCBS 239 compliance action-plan proposal

For some years now, master data has become extremely relevant to business success and continuity in an increasingly competitive and global business environment. The banking sector is one example of how the implementation of well-structured and designed master data management policies and initiatives is crucial for reaching positive results. One of the areas in which banks need to ensure extremely fruitful master data management approaches and data governance procedures is when dealing with risk-related data, as it not only ensures accurate and well-supported management and decision-making, but also because banks are required to do so by imposed regulations, such as the BCBS 239. Drawing on a DSR methodology supported research project, where banking and IS-related expertise was continuously merged with existing theoretical knowledge on MDM and BCBS 239 related topics, and a permanent focus on the technical and functional complexity associated with implementing master data management and well-established data governance procedures that ensure regulatory compliance, we propose a novel, six-phase action plan that will allow banks to ensure compliance with BCBS 239 and, consequently, ensure efficient and effective risk data management and reporting.

Predictors of not Achieving Remission or Low Disease Activity in Axial Spondyloarthritis Patients from Middle Eastern Countries: A Prospective, Multicenter, Real-world Study.

ObjectivesWe sought to identify the predictors of not achieving remission or low disease activity (LDA) among axial spondyloarthritis (SpA) patients in four Middle Eastern countries.MethodsIn this multicenter prospective real-world study, adult patients with axial SpA diagnosed clinically during January–June 2019, and who met the Assessment of SpondyloArthritis International Society classification criteria for axial SpA, were enrolled from the participating centers of four countries—Lebanon, Oman, Qatar, and the UAE. Patient demographics, disease history, comorbidities, treatment, and compliance data were obtained at baseline. The primary outcome was to determine the percentage of patients who did not achieve the clinical target of remission or LDA as indicated by Ankylosing Spondylitis Disease Activity Score-C-reactive protein (ASDAS-CRP) < 2.1 after a three-month follow-up period. Secondary outcomes were assessing the demographic and clinical characteristics of ‘achievers’ and ‘non-achievers’ and to study the predictors of ASDAS-CRP ≥ 2.1 in different clinical subsets.ResultsThe participants were 309 patients of both sexes, with a median age of 43 years. Women had a slight majority (53.7%). At the end of the study, 72.2% of patients achieved the clinical target of ASDAS-CRP < 2.1. Non-achievers were significantly more likely to have enthesitis, positive human leukocyte antigen B 27 status, psoriasis, peripheral involvement, fibromyalgia, and a lower score on Compliance Questionnaire for Rheumatology (CQR). Multiple regression analysis showed that low CQR score, enthesitis, psoriasis, and family history of SpA were independent predictors of ASDAS-CRP ≥ 2.1.ConclusionsThis real-world study suggests that low compliance, positive human leukocyte antigen B 27 status, peripheral involvement, and presence of enthesitis, psoriasis, and fibromyalgia are predictors of not achieving remission or LDA in axial SpA patients.

0091 The Practicality of Implementing Nightly Remote Patient Monitoring (RPM) of OSA Patients in Clinical Practice

Abstract Introduction If Remote Patient Monitoring (RPM) is to become integrated into sleep medicine practices, patient compliance and reliability of data acquisition needs to be determined. We developed the REST Tracker platform to monitor OSA patients nightly, using an oximeter ring with data analyzed by a recognized method (1) to render a sAHI that has been FDA approved (FDA reference number K182618) providing an equivalent to the AHI. The REST Tracker tracks the sAHI along with multiple other parameters, providing the clinician nightly physiologic data to assist in OSA management decisions. Here we present patient compliance and system reliability data. Methods Data obtained from a ring pulse oximeter worn nightly is transmitted by Bluetooth to a cellular device at the bedside. Nightly data from bedtime to final morning awakening is transmitted to the cloud and retrieved by the REST Tracker system which tabulates and displays the data in a format that assists the clinician in OSA management decisions. Compliance and reliability performance criteria used to assess the REST Tracker system were as follows: Patient Retention Rate (patients were considered a Drop Out if there was no usage within 15 days prior study termination on Dec 15th), Data Acquisition Reliability = percentage of nights with &amp;gt; 3 hours of data on those nights the ring was used. Successful Monitoring Achieved if a patient had over 70% of nights containing &amp;gt; 3 hours of data. Data acquisition was initiated on 1/1/21 and ended 12/15/21 with a minimum of 6 weeks of monitoring. Results A total 38 patients (28 M / 10 F) Ave age 60 (SD +/-13) enrolled from 1/1/21 to 10/31/21, and acquisition ended 12/15/21. Monitoring ranged from 6 to 50 weeks. 10 patients dropped out, rendering a 74% Patient Retention Rate. Data was collected for a total 4072 nights from all patients, of which 3441 nights had &amp;gt; 3 hrs of data, rendering an overall Data Acquisition Reliability of 84.5%. There were 33 patients that achieved Successful Monitoring (87%) as defined above. Conclusion In our practice RPM has been well accepted with 74% Patient Retention Rate and 87% achieving Successful Monitoring. This study demonstrated the feasibility of this approach. We are currently implementing methods to achieve higher retention successful monitoring rates. The REST Tracker has been used in our practice for the management of OSA patients undergoing a variety of treatments approaches ranging from PAP, dental appliances and Inspire (HGNS). The REST Tracker has enhanced our ability to assess these patients on an ongoing basis, decreased the need for in lab sleep testing and expedited management decisions. Clinical cases are currently being accumulated and will be presented to demonstrate the utility of the REST Tracker RPM approach. Support (If Any) Reference: (1) Al Ashry HS, Hilmisson H, Ni Y, Thoms RJ, Investigators A. Automated Apnea-Hypopnea Index from Oximetry and Spectral Analysis of Cardiopulmonary Coupling. Ann Am Thorac Soc. 2021;18(5):876-83.

Compliance with the surgical safety checklist in Switzerland: an observational multicenter study based on self-reported data

BackgroundSince publication of the surgical safety checklist by the WHO in 2009, it has been introduced in many hospitals. However, frequency and quality of surgical safety checklist use is often low probably limiting the effectiveness of the checklist in preventing patient harm. The focus of this study was to examine the current state of compliance with the surgical safety checklist in Switzerland and to evaluate how the data relates to international comparative data.MethodsBetween November 2020 and March 2021 twelve hospitals with 15 sites collected for at least 200 surgical interventions each whether the three sections of the surgical safety checklist (Sign In, Team Time Out, Sign Out) have been applied. This data collection was part of a large quality improvement project focusing on measuring and improving compliance with the surgical safety checklist via peer observation and feedback. Descriptive statistics were used to analyze the data; chi-square tests were used to compare sub-samples.ResultsThe hospitals collected valid compliance data for 8622 surgical interventions. Mean compliance rate was 91% when distinguishing between the two categories applied (including partially applied) and not applied. In line with previous research, Sign In (93%) and Team Time Out (94%) sections have been applied more frequently than Sign Out (86%). All three surgical safety checklist sections have been applied in 79% of the surgical interventions, no sections in 1%.ConclusionsThe results of this study indicate that the overall application of the surgical safety checklist in Switzerland can be considered high, although the completeness, especially of the Sign Out section, could be improved. At present, it seems difficult to compare compliance rates from different studies as measurement methods and definitions of compliance vary widely. A systematization and homogenization of the methodology within, but also beyond, national borders is desirable for the future.

0861 Sleepy in the Mountains

IntroductionCentral sleep apnea (CSA) is a rare disorder caused by a reduction of airflow and ventilatory effort during sleep. CSA is rarely idiopathic and associated with medical conditions including heart failure, opioid medications, treatment emergent and high-altitude periodic breathing. At higher altitudes, hypoxemia induces periodic breathing with periods of deep and rapid breathing alternating with central apnea. Patients with high-altitude periodic breathing experience fragmented sleep, poor sleep quality, excessive daytime sleepiness, morning headaches and witnessed apnea. We discuss a patient with obstructive sleep apnea (OSA) who developed new-onset central sleep apnea after relocating to a higher altitude location. Report of Cases: A 75-year-old male with a history of moderate obstructive sleep apnea well controlled on CPAP for eight years, with no known cardiovascular or pulmonary disease, presented with new-onset excessive daytime sleepiness. He had recently relocated to an area in the Colorado mountains (7000 ft elevation) from his previous home in Los Angeles (sea level). His residual apneahypopnea index (r-AHI) displayed on his CPAP machine increased to 7-14/hr from his normal of 1-2/hr after his relocation. Review of his compliance data revealed his central apnea index was elevated, contributing to his high r-AHI. A one-night nocturnal oximeter was mailed to the patient to use while on CPAP. Data revealed oxygen desaturation to less than 88% for about 2 hours of the night, worse during the early morning hours. The patient was advised to undergo a polysomnography and adaptive servo-ventilation titration if significant central sleep apnea was present. The patient declined due to concern about the COVID-19 pandemic. Supplemental nocturnal oxygen was initiated at 2L/min with normalization of the r-AHI.ConclusionPatients with OSA who experience worsening symptoms or increased r-AHI despite excellent compliance with PAP therapy should be considered for repeat polysomnography or titration study. While it is expected that high-altitude central sleep apnea will improve with acclimatization, nocturnal supplemental oxygen in addition to PAP therapy is indicated for patients with high-altitude central sleep apnea to diminish hypoxemia and improve residual AHI and sleep quality.Support (If Any)

Nursing Documentation and Activities when Using a Clinical Decision Support System for Sepsis and Clinical Deterioration Management.

The role of nurses in the management of sepsis and clinical deterioration, and the potential use of Clinical Decision Support Systems to identify patients' undesired outcomes are well recognized. In order to verify the association of such a system adoption in the compliance of a hospital sepsis protocol on the nurses' workflow and documentation, a three-stage study was conducted. Main findings show that there is no statistically significant difference between the sepsis protocol compliance data from before and after the system implementation; that nursing caring-related activities are a priority over documentation and time spent using the system; and that it was possible to validate a proposal of nursing documentation for sepsis and clinical deterioration. This contributes to the improvement of nurses' awareness of their engagement in nursing informatics issues in the era of big data.

Compliance to playpen usages to enhance parental supervision of under-five children in rural community of Bangladesh.

IntroductionIn Bangladesh, injury is one of the leading causes of death and morbidity in children. All children under 5 years of age are at high risk for drowning though the risks are highest when children first learn to walk and crawl while they do not understand the danger of water. The Centre for Injury Prevention and Research, Bangladesh (CIPRB) in collaboration with Johns Hopkins International Injury Research Unit (JH-IIRU) has been implementing two drowning prevention interventions, providing playpens and community day care centres (anchal), or both in three rural sub-districts of Bangladesh under Saving of Lives from Drowning (SoLiD) project in Bangladesh. In CIPRB intervention areas, wooden playpens were distributed among the children nine months to three years at household (HH) level.ObjectiveThe aim of this study was to explore and understand the acceptability and perceptions of parents towards playpen and its relevance for drowning and injury related mortality and morbidity prevention.MethodsAnchal mothers (‘anchal maa’ in Bangla) distributed 30,553 playpens and collected compliance information at the HH level using a structured questionnaire. 1600 trained anchal maas collected data via face to face interviews from May 2014 to November 2015. Playpen compliance visits were conducted periodically on the second and seventh days and every two months after delivering the playpen. Data were entered using standard data entry formats and analyzed using SPSS software version 23.ResultsParents reported that playpen is a safe place and protects children from drowning and other injuries. During compliance data collection, anchal maa founds that 71.8% of all children were using playpen and 93.7% (of 71.8%) children were playing inside the playpen while mothers were busy with their household chores like cooking, washing dishes and clothes, taking care of their poultry and domestic animals etc. 95.7% parents reported playpen is being used for keeping the child safe. On an average, the children were placed two to six times per day in a playpen. 99.1% of the children who reported using a playpen did not get any injuries (falls, cuts and bruises) while using the playpen. Satisfaction level with the playpen intervention among mothers was 90.5%. Some respondents suggested improving the playpen utilization by providing toys, adding wheels for ease of mobility, and increasing the height.ConclusionThe playpens were found to be well accepted and utilized for the children, especially when mothers were busy with their household chores.

Compliance study of hip protector users for prevention of fragility fracture: A pilot randomized trial

Hip protectors have been widely used for hip fracture prevention in the elderly, but its efficacy remains controversial. Users' compliance to hip protector is an important factor for its efficacy. However, the assessment of users' compliance tended to be subjective and unreliable in the past. To quantify the elderly's compliance to hip protectors and investigate the effect of different underpant designs on the elderly's compliance. A pilot randomized trial. Thirty-one participants were recruited and provided with hip protectors in which compliance monitors were installed and delivered with three pairs of either the conventional underpants or the purpose-design underpants randomly. Participants were encouraged to use the hip protectors with the assigned underpants for whole day. After 4 weeks, compliance data were downloaded from the compliance monitors. Participants were also asked to fill a survey form for acceptance analysis. The Spearman correlation coefficient and the Wilcoxon signed-rank test/2 independent samples t test/Mann-Whitney U test were used for the corresponding statistical analyses. Thirty-one participants were recruited initially. Eighteen participants were excluded from instrumented compliance analysis because of limited or no data collection. The data of the resting 13 participants (six in the conventional underpants group and seven in purpose-design underpants group) were analyzed and showed an average instrumented compliance of 77.5% which was lower than the average self-reporting compliance (83.3%) of all the available 23 participants (eight of 31 became wheelchair-bounded). Participants' compliance was positively correlated with their acceptance to the hip protectors and significantly higher in the purpose-design underpants group than in the conventional underpants group ( P < 0.05). This pilot study demonstrated a feasible protocol for compliance quantification of the elderly to the hip protectors, the importance to have an objective compliance measure to assess users' actual compliance, and purpose-design underpants could improve the users' compliance. Future studies with long-term observation and large sample size deserve further proof of the current findings.

Remote Patient Management Facilitates Guideline Directed Medical Therapy Improving Outcomes.

<h3>Introduction</h3> Prior Remote Patient Management (RPM) studies in Heart Failure (HF) yielded mixed results. These trials did not achieve sufficient patient and/or clinician compliance, used different monitoring tools, and failed to integrate RPM into daily workflow. GDMT is the most evidenced based strategy for HF management. However, episodic office visits (OV) do not adequately achieve optimization of therapy. Real-time, data-based, therapeutic adjustments using RPM drives better outcomes through improved HF management. A patient-centric RPM approach improves compliance, decreases OV, and reduces hospitalizations. Ultimately, this should lead to less morbidity and increased longevity. Establishing workflows that incorporate GDMT enabled by RPM is essential for providers to achieve next generation HF care. <h3>Hypothesis</h3> RPM will reduce HF hospitalizations and Emergency Department (ED)/Hospital Outpatient IV diuretic visits. <h3>Methods</h3> We retrospectively studied the 2-year experience of 40 subjects with New York Heart Association Class II or Class III HF regardless of EF. All patients utilized the Cordella Heart Failure System to transmit daily weight, blood pressure, heart rate, and pulse-ox data, as well as symptoms via wireless tablet. The cardiologist and nursing staff established workflow patterns to facilitate daily monitoring. GDMT optimization recommendations and lifestyle adjustments were communicated to patients via telephone and tablet-based messaging. <h3>Results</h3> Patient compliance (data sent 5 of 7 days) was >90% (after patient training) and increased to 95% 2 years later. Clinician compliance (checking data at least twice weekly) was 100%. HF hospitalizations and ED/Hospital Outpatient IV diuretic visits were reduced as shown in Table 2. Volume of phone calls leading to medication changes increased 6-fold with RPM while OV decreased by 14.5%. HF hospitalizations decreased by nearly 85%. <h3>Conclusion</h3> New workflow patterns allowed this practice to use RPM to facilitate real-time GDMT optimization and lifestyle changes that achieved reduced HF Hospitalizations, OV, and HF ED/Hospital Outpatient IV diuretic visits with excellent patient compliance.

Impact of Dispense Tracking Software on Inpatient Pharmacy Operations.

Background: When medications dispensed from a hospital inpatient pharmacy aren't able to be found at their intended destination (ie, a missing dose), this can result in delayed medication administration and rework to redispense the medication. Technology advancements in the medication use process have led to development of dose-tracking software that has the capability to track medication doses throughout the medication use cycle and document a medication's location to its destination. Objective: The primary objective of this study was to evaluate the impact of dose-tracking software on the number of inpatient pharmacy redispenses and nursing requests for missing medications. Secondary objectives included pharmacy staff satisfaction with dose-tracking software, its impact on workflow and patient safety, and compliance with dose-track scanning. Methods: The study design was a prospective, pre-post implementation to compare the requests for missing doses and associated dispenses of injectable medications during the set evaluation period. Dose-track scanning compliance data was collected and evaluated. A survey was also administered to staff to evaluate employee perception and satisfaction with usability and value of the software. Results: During the preimplementation period, 40 021 injectable doses were dispensed, and 9841 (24.6%) were documented as redispensed doses. After dose-tracking implementation, 42 975 total injectable doses were dispensed with 9839 (22.9%) being redispensed. The count of medication messages was 10 661 in the preperiod and 11 475 in the postperiod. The data were normalized using case mix index (CMI) and patient days to account for variation in severity of illness. Conclusion: Implementation of dose-tracking software showed a decrease in the percentage of redispensed injectable medications.

A Pilot Feasibility Study of a Combined Supervised- and Home-Based Exercise to Improve Cancer-Related Symptoms in 1-3 Colorectal Cancer Patients

PURPOSE: To assess the feasibility of a home-based exercise program specifically developed to improve bowel/defecatory and physical function in stage 1–3 colorectal cancer patients.METHODS: A total of 15 (56.7 years, 6 men and 9 women) stage 1–3 colorectal cancer survivors were recruited. Participants in the exercise group met with an exercise therapist once a week, 6 times over 6 weeks, where 1-hour exercise sessions (12 different resistance exercises, 10–15 reps, 2–3 sets) and an education session were provided. Participants in the exercise group were then asked to carry out the same exercises daily, at home. Their compliance was monitored through daily exercise logs. Participants in the control group did not receive any exercise education or intervention. Anthropometric measurements, physical function, and quality of life were assessed at baseline and at the 6th week in both groups. In-depth interviews were conducted with participants in the exercise group for a qualitative study.RESULTS: All 15 participants completed the trial and their data were included in the analyses. Stool frequency, flatulence, and embarrassment were significantly improved in the exercise group (pre vs. post, p&lt;.05), while flatulence and embarrassment were significantly improved in comparison to the control group (between-group p-value=.014, and .025 respectively). Through in-depth interviews, participants reported that their body composition, physical fitness, and physical function improved, while symptoms such as fatigue, insomnia, stool frequency, flatulence, and embarrassment reduced after participation in the exercise program.CONCLUSIONS: Our pilot feasibility study showed that home-based exercises provided to colorectal cancer survivors were feasible based on their compliance and qualitative data. In addition, participation in the current exercise program resulted in improvement in their bowel and defecatory function and quality of life.

Sediment quality of the Ridracoli fresh water reservoir in Italy: Insights from aqua regia digestion and sequential extractions

The inter-element relationships and the forms in which metals exist strongly influence their mobility and, in turn, have a signature on the environment and human health. Located in the northern Apennines within the Emilia-Romagna region, the Ridracoli artificial lake is one of Italy's most important reservoirs that provides drinking water for about one million people. This work characterized the reservoir sediments by ICP-MS after aqua regia digestion (ARD), comparing the limits by law to assess environmental compliance and XRF data from the same sample-set taken as total concentrations. The Degree of Extraction (DE) from pseudo-total concentrations of ARD analysis allows assessing elements mobility and the associated environmental risk. Principal Component Analysis (PCA) on the obtained data helped to investigate inter-element relationships better; for example, we observed carbonate-sourced sediments, many trace elements (e.g., Ni, Zn) linked to FeMn oxyhydroxides, the importance of the grain size in elements distribution, and the central role of the organic matter in element partitioning. In addition, a Sequential Extraction Procedure (SEP) was applied to the sediment samples to understand the partitioning of many analytes, including Potentially Harmful Elements (PHE) such as Fe, Mn, Cu, Cr, Ni, Pb, and Zn. The results indicated that the most easily mobilized forms were predominant in the area near the dam, in correspondence to sediments affected by the formation of a seasonal anoxic layer.

Tumour treating fields in glioblastoma: is the treatment tolerable, effective, and practical in UK patients?

Background Tumour Treating Fields (TTF) in combination with standard therapy, prolongs survival in patients with glioblastoma (GBM). The aim of the current study was to assess the feasibility of integrating TTF into a standard UK neuro-oncology service with a focus on patient tolerability, compliance, and treatment delivery. Methods A prospective study was performed of UK patients with IDH 1 Wild Type, MGMT Unmethylated GBM treated with TTF, in conjunction with conventional therapy. Patient compliance data, device-specific tolerability questions, and an evaluation of disease progression and survival were collected. Monthly quality of life (QoL) questionnaires (EORTC QLQ-C30 with BN-20) examined the trend of global health, psychosocial function, and symptom progression. Results Nine patients were enrolled with a median age of 47 (seven males; two females). Overall, compliance with TTF was 89% (range 16–97%). Only one patient failed to comply with treatment. Patients tolerated the device with minimal side effects. Eight patients described mild to moderate skin irritation, whilst all patients were keen to recommend the device to other patients (100%). Most patients found the weight and size of the device to be its biggest drawback (72%). Progression-free survival was 5.5 months and median overall survival was 14.9 months. Conclusions TTF was well-tolerated amongst a small cohort of UK patients, who were able to comply with treatment without any significant complication. QoL questionnaires showed no sustained deterioration in global health, physical and emotional function until the final months of life when the disease burden was greatest.